Volume 82, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Despite being free of charge, treatment adherence to 7-day primaquine for the radical cure of was estimated at 62.2% among patients along the Iquitos-Nauta road in the Peruvian Amazon. The principal reason for non-adherence was the perceived adverse effects related to local humoral illness conceptions that hold that malaria produces a hot state of body, which is further aggravated by the characteristically hot medical treatment. Notably, patients were willing to adhere to the first 3 days of treatment during which symptoms are most apparent and include the characteristic chills. Nevertheless, as symptoms abate, the perceived aggravating characteristics of the medication outweigh the perceived advantages of treatment adherence. Improving community awareness about the role of primaquine to prevent further malaria transmission and fostering a realistic system of direct observed treatment intake, organized at community level, can be expected to improve adherence to the radical cure of in this area.


Article metrics loading...

Loading full text...

Full text loading...



  1. Oficina General de Epidemiologia, DIRESA Loreto, 2008. Análisis de la situación de salud de la region Loreto año 2007. Available at: http://www.dge.gob.pe/asis_inddep.php. Accessed October 25, 2009.
  2. Baird KJ, Rieckmann K, , 2003. Can primaquine therapy for vivax malaria be improved? Trends Parasitol 19: 115120.[Crossref]
  3. Burke L, Ockene I, , 2001. Compliance in Health Care and Research. New York: Futura.
  4. Einarson T, , 1993. Drug-related hospital admissions. Ann Pharmacother 27: 832840.[Crossref]
  5. Yeung S, White N, , 2005. How do patients use antimalarial drugs? A review of the evidence. Trop Med Int Health 10: 121138.[Crossref]
  6. Roper M, Carrion Torres R, Cava Goicochea C, Anderson E, Aramburu Guarda J, Calampa C, Hightower A, Magill A, , 2000. The epidemiology of malaria in an epidemic area of the Peruvian Amazon. Am J Trop Med Hyg 62: 247256.
  7. Branch O, Casapia WM, Gamboa DV, Hernandez JN, Alava FF, Roncal N, Alvarez E, Perez EJ, Gotuzzo E, , 2005. Clustered local transmission and asymptomatic Plasmodium falciparum and Plasmodium vivax malaria infections in a recently emerged, hypoendemic Peruvian Amazon community. Malar J 4: 27.[Crossref]
  8. Roshanravan B, Kari E, Gilman RH, Cabrera L, Lee E, Metcalfe J, Calderon M, Lescano AG, Montenegro SH, Calampa C, Vinetz JM, , 2003. Endemic malaria in the Peruvian Amazon region of Iquitos. Am J Trop Med Hyg 69: 4552.
  9. Schoeler G, Flores-Mendoza C, Fernandez R, Davila J, Zyzak M, , 2003. Geographical distribution of Anopheles darlingi in the Amazon basin region of Peru. J Am Mosq Control Assoc 19: 286296.
  10. Vittor A, Gilman R, Tielsch J, Glass G, Shields T, Lozano W, Pinedo Cancino V, Patz J, , 2006. The effect of deforestation of the human-biting rate of Anopheles darlingi, the primary vector of falciparum malaria in the Peruvian Amazon. Am J Trop Med Hyg 74: 311.
  11. Aramburu Guarda J, Ramal Asayag C, Witzig R, , 1999. Malaria reemergence in the Peruvian Amazon region. Emerg Infect Dis 5: 209215.[Crossref]
  12. Harvey SA, Paredes Olórtegui M, Leontsini E, Bustamante Pezo C, Olórtegui Pezantes LM, Winch PJ, , 2008. The whole world will be able to see us: determining the characteristics of a culturally appropriate bed net among Mestizo communities of the Peruvian Amazon. Am J Trop Med Hyg 79: 834838.
  13. The Global Fund, 2009. Peru and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Available at: http://www.theglobalfund.org/programs/country/?lang=en&CountryId=PER. Accessed July 1, 2009.
  14. Ministerio de Salud, 2007. Norma técnica de salud para la atención de la malaria y malaria grave en el Perú. Lima, Peru: MINSA Perú.
  15. Institute of Tropical Medicine Antwerp-Belgium, 2009. Annual Activity Report 2008. Available at: http://www.itg.be/itg/Uploads/Bibliotheek/Jaarverslag%202008.pdf. Accessed October 25, 2009.
  16. Seale C, , 1999. The Quality of Qualitative Research. London: Sage.[Crossref]
  17. Ragin C, , 1994. Constructing Social Research: The Unity and Diversity of Method. USA: Pine Forge Press.
  18. Mays N, Pope C, , 1995. Qualitative research: observational methods in health care settings. BMJ 311: 182184.[Crossref]
  19. Pope C, Mays N, , 1995. Qualitative research: reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. BMJ 311: 4245.[Crossref]
  20. Tashakkori A, Teddlie C, , 1998. Mixed Methodology: Combining Qualitative and Quantitative Approaches (Applied Social Research Methods). London: Sage.
  21. Crabtree B, Miller L, , 1992. Doing Qualitative Research (Research Methods for Primary Care). London: Sage.
  22. American Anthropological Association, 1998. Code of Ethics of the American Anthropological Association. Available at: www.aaanet.org/committees/ethics/ethcode.htm. Accessed September 14, 2008.
  23. American Anthropological Association, 2004. American Anthropological Association Statement on Ethnography and Institutional Review Boards. Available at: http://www.aaanet.org/stmts/irb.htm. Accessed September 14, 2008.
  24. Foster G, , 1993. Hippocrates' Latin American Legacy: Humoral Medicine in the New World. London: Routledge.
  25. Mendis K, Sina B, Marchesini P, Carter R, , 2001. The neglected burden of Plasmodium vivax malaria. Am J Trop Med Hyg 64 (Suppl 1–2): 97106.
  26. Yepez M, Zambrano D, Carrasco F, Yepez R, , 2000. Factores asociados con el incumplimiento del tratamiento antipaludico en pacientes ecuatorianos. Rev Cubana Med Trop 52: 8189.
  27. Llanos Zavakagal F, Cotrina A, Campana P, , 2001. Factores asociados a la adherencia al tratamiento de Malaria en Pirua y Tumbes-Peru. Revista Peruana de Medicina Experimental y Salud Pública 18: 6370.
  28. van Dulmen S, Sluijs E, van Dijk L, de Ridder D, Heerdink R, Bensing J, , 2007. Patient adherence to medical treatment: a review of reviewers. BMC Health Serv Res 55.

Data & Media loading...

  • Received : 04 Sep 2009
  • Accepted : 27 Nov 2009

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error